Surveillance of Individuals at High Risk for Developing Pancreatic Cancer

__Abstract__ We still face great difficulties to treat and cure patients with pancreatic ductal adenocarcinoma (henceforth referred to as pancreatic cancer). The survival is dismal even in those who undergo intended curative surgery in case of a localized tumor. Despite the relatively low incidence of 9-12 per 100.000 per year in Western populations (approximate lifetime-risk 1.0%), pancreatic cancer is ranked among the to

Measurement-induced focusing and the magnitude of loss aversion:The difference between comparing gains to losses and losses to gains

Research has identified loss aversion as a strong and robust phenomenon, but has also revealed some moderators affecting the magnitude of its effect on decision making. In the current article, we draw attention to the fact that even the measurement of loss aversion itself may affect its magnitude by inducing a focus on either losses or gains. In three studies, we provide empirical evidence for such a measurement-induced focus. In all studies we used coin-toss gambles---in which there is a 50/50 chance to win or to lose---to assess gain/loss ratios as a measure of loss aversion. Participants either filled out the loss side or the gain side of this gain/loss ratio. The studies consistently showed that---using within- and between-subject designs and anticipated and real coin-toss gambles---the strength of loss aversion depended on the measurement format (fill-in-the-loss versus fill-in-the-gain); filling in the loss side increased loss aversion. Moreover, loss aversion was more affected by the stakes of the gamble in the fill-in-the-loss format than in the fill-in-the-gain format

Tomorrow is another day: how motives of entrepreneurship relate to the pursuit of business growth

Past research has suggested that small business growth plays an important role in economic growth. This paper presents three studies that examined the psychological process underlying the relationship between motives of entrepreneurship and business growth pursuit by focusing on the role of time perspective. The results from three studies (Study 1, N = 142, and Study 2, N = 181, mostly Western small‐business owners; Study 3, N = 254, Indonesian small‐business owners) demonstrated that opportunity‐based entrepreneurship was positively associated with business growth pursuit through increased future time perspective (Studies 1 to 3), whereas necessity‐based entrepreneurship was negatively associated with business growth pursuit through increased present time perspective and decreased future time perspective (Study 3). These findings help explain why some business owners avoid business growth by highlighting the vital role of time perspective in explaining why and how motives of entrepreneurship relate to the pursuit of business growth across social and cultural contexts.Social decision makin

Notes on Stein-Sahi representations and some problems of non L2L^2 harmonic analysis

We discuss one natural class of kernels on pseudo-Riemannian symmetric spaces.Comment: 40p

Action of overalgebra in Plancherel decomposition and shift operators in imaginary direction

Consider the Plancherel decomposition of the tensor product of a highest weight and a lowest weight unitary representations of $SL_2$. We construct explicitly the action of the Lie algebra $sl_2 + sl_2$ in the direct integral of Hilbert spaces. It turns out that a Lie algebra operator is a second order differential operator in one variable and second order difference operator with respect to another variable. The difference operators are defined in terms of the shift in the imaginary direction $f(s)\mapsto f(s+i)$, $i^2=-1$ (the Plancherel measure is supported by real $s$).Comment: 12 page

Surveillance for pancreatic cancer in high-risk individuals

Background Surveillance of individuals at high risk of pancreatic ductal adenocarcinoma (PDAC) and its precursors might lead to better outcomes. The aim of this study was to determine the prevalence and outcomes of PDAC and high-risk neoplastic precursor lesions among such patients participating in surveillance programmes. Methods A multicentre study was conducted through the International CAncer of the Pancreas Screening (CAPS) Consortium Registry to identify high-risk individuals who had undergone pancreatic resection or progressed to advanced PDAC while under surveillance. High-risk neoplastic precursor lesions were defined as: pancreatic intraepithelial neoplasia (PanIN) 3, intraductal papillary mucinous neoplasia (IPMN) with high-grade dysplasia, and pancreatic neuroendocrine tumours at least 2 cm in diameter. Results Of 76 high-risk individuals identified in 11 surveillance programmes, 71 had undergone surgery and five had been diagnosed with inoperable PDAC. Of the 71 patients who underwent resection, 32 (45 per cent) had PDAC or a high-risk precursor (19 PDAC, 4 main-duct IPMN, 4 branch-duct IPMN, 5 PanIN-3); the other 39 patients had lesions thought to be associated with a lower risk of neoplastic progression. Age at least 65 years, female sex, carriage of a gene mutation and location of a lesion in the head/uncinate region were associated with high-risk precursor lesions or PDAC. The survival of high-risk individuals with low-risk neoplastic lesions did not differ from that in those with high-risk precursor lesions. Survival was worse among patients with PDAC. There was no surgery-related mortality. Conclusion A high proportion of high-risk individuals who had surgical resection for screening- or surveillance-detected pancreatic lesions had a high-risk neoplastic precursor lesion or PDAC at the time of surgery. Survival was better in high-risk individuals who had either low- or high-risk neoplastic precursor lesions compared with that in patients who developed PDAC

Evolution of features of chronic pancreatitis during endoscopic ultrasound-based surveillance of individuals at high risk for pancreatic cancer

Background and study aims During endoscopic ultrasound (EUS)-based pancreatic ductal adenocarcinoma (PDAC)-surveillance in asymptomatic individuals, features of chronic pancreatitis (CP) are often detected. Little is known about the prevalence and progression of these features. The aim of this study was to quantify these features, assess the interobserver agreement, assess possible associated factors, and assess the natural course during 3 years of follow-up. Patients and methods Two experienced endosonographers reviewed anonymized sequential EUS videos of participants in PDAC surveillance that were obtained in 2012 and 2015 for features of CP. Descriptives, agreement analyses, univariate and multivariate analyses for possible risk factors, and repeated measures analyses to assess intra-individual changes over time were performed. Results A total of 42 EUS videos of 21 participants were reviewed. Any feature of CP was present in 86 % (2012) and 81 % (2015) of participants, with a mean of 2.5 features per individual. The overall interobserver agreement was almost perfect at 83 %. No baseline factors were significantly associated with features of CP. Features did not change over time, except for hyperechoic foci without shadowing, which decreased intra-individually (β = – 1.6, P = 0.005). Conclusions This blinded study shows features of CP to be highly prevalent in individuals at high risk of developing pancreatic cancer. No baseline factors were associated with presence of these features. CP features did not increase intra-individually over a 3-year period. Longer follow-up and pathological examination of pancreatic resection specimens will be essential to learn whether EUS detection and follow-up of these CP features bear clinical relevance